Healthcare spending is currently over 18% of GDP in the US, almost twice the average of other developed countries. US National Health Expenditures hit $3.5 trillion in 2017 and are expected to reach $5.7 trillion by 2026. About 10% of Americans remain uninsured, mostly working age adults who say they just can’t afford the premiums or out-of-pocket costs.

Fraud and waste are why US healthcare is so damn expensive. An estimated 10% of Medicare/Medicaid is lost to fraud. As for waste, at least 20% of US healthcare spending is unnecessary due to:

Imagine if the US cut healthcare spending by a quarter. That would shave off almost a trillion dollars - enough to fund a healthcare system where everyone is covered and everyone’s paying less. All it takes is political will, including a willingness to face down the AMA.

Here are a few suggestions:

Stay with a multi-payer system, but with strict cost controls, like Japan and Germany.

Develop fee schedules for diagnostic procedures, treatment, and medical equipment, set by federal or regional governments, like Japan and Canada. Public and private payers would use the same fees schedule, streamlining the medical billing process (i.e., reducing administrative complexity)

Some beneficial side effects: personal bankruptcies would be cut in half and employers would have more money to increase wages. And for those who want more choice and easy access to specialists, fine. All you have to do is pay for it.